Health Care Fraud and Abuse

Health Care Fraud and Abuse
Author: Aspen Health Law Center
Publisher:
Total Pages: 156
Release: 1998
Genre: Business & Economics
ISBN:

Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.

Section 1557 of the Affordable Care Act

Section 1557 of the Affordable Care Act
Author: American Dental Association
Publisher: American Dental Association
Total Pages: 60
Release: 2017-05-24
Genre: Medical
ISBN: 1941807712

Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.

The Affordable Care Act

The Affordable Care Act
Author: Tamara Thompson
Publisher: Greenhaven Publishing LLC
Total Pages: 130
Release: 2014-12-02
Genre: Young Adult Nonfiction
ISBN: 0737771496

The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

Patient Protection and Affordable Care ACT - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Patient Protection and Affordable Care ACT - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 78
Release: 2018-07-05
Genre:
ISBN: 9781722602420

Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants. It finalizes the requirement that Exchanges must have a certified application counselor program. It creates conflict-of-interest, training and certification, and meaningful access standards; clarifies that any licensing, certification, or other standards prescribed by a state or Exchange must not prevent application of the provisions of title I of the Affordable Care Act; adds entities with relationships to issuers of stop loss insurance to the list of entities that are ineligible to become Navigators; and clarifies that the same ineligibility criteria that apply to Navigators apply to certain non-Navigator assistance personnel. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Exchange Functions - Standards for Navigators and Non-Navigator Assistance Personnel (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicare Program Integrity

Medicare Program Integrity
Author: U.s. Government Accountability Office
Publisher:
Total Pages: 38
Release: 2017-08-04
Genre:
ISBN: 9781974244263

"Why GAO Did This StudyAccording to the Centers for Medicare & Medicaid Services (CMS)-the agency within the Department of Health and Human Services (HHS) that administers the Medicare program-more than 1.5 million health providers and suppliers of medical equipment were enrolled in the Medicare program in 2011, and 30,000 more enroll each month. CMS has established Medicare enrollment standards and procedures intended to ensure that only qualified providers and suppliers can enroll. While most providers and suppliers pose a limited risk to the Medicare program, our previous work found persistent weaknesses in CMS's Medicare enrollment standards and procedures that increased the risk of enrolling entities intent on defrauding the program. In 2010, the Patient Protection and Affordable Care Act (PPACA) authorized CMS to implement procedures to strengthen the Medicare enrollment process.GAO was asked to review CMS's Medicare provider enrollment procedures. In this report, GAO describes (1) how CMS and its contractors use provider and supplier enrollment information to prevent improper payments and factors that may affect the usefulness of this information, and (2) the extent to which CMS has implemented new provider and supplier enrollment screening procedures since the enactment of PPACA. To do so, GAO reviewed relevant regulations and documents, and interviewed officials from CMS"